Many health conditions are characterized by infection and/or inflammation, such as various conditions of the eyes, ears, nose, and throat. While often difficult to discern underlying causes in a particular case, such conditions may be treated with, for example, topical or systemic antibiotics, antivirals, and/or anti-inflammatory agents depending on the suspected etiology. Such treatments are however limited by microbial resistance, drug toxicity, irritation, and/or hypersensitivity that may develop. Methods and compositions for broadly, effectively, and safely treating infected regions and/or inflammatory conditions of the body are needed.
For example, conjunctivitis, commonly known as pink eye, is an inflammation of the conjunctiva, the outer-most layer of the eye that covers the sclera. While many of the signs and symptoms of conjunctivitis are relatively non-specific, there are several etiologies that may be causative in a given case. The three most common causes of conjunctivitis are bacterial infection, viral infection, or an allergic reaction.
Bacterial conjunctivitis is commonly caused by Staphylococcus and Streptococcus bacteria, and in the case of newborns, may result from vertical transmission of Neisseria or Chlamydia from an infected mother. The symptoms and the severity of bacterial conjunctivitis depend on the bacteria involved. For example, when caused by a pyogenic bacteria, the infection may produce a stringy, opaque discharge that may cause matting of the eyelids. There may be severe crusting of the infected eye and surrounding skin. Where bacterial conjunctivitis is suspected, the condition is treated with an antibiotic effective for a broad range of bacteria. Where initial antibiotic treatment is unsuccessful, bacterial cultures can be initiated to guide treatment, although negative results are fairly common since some bacteria implicated in conjunctivitis are not easily cultured by usual laboratory culturing methods. Bacterial conjunctivitis can be quite contagious, and easily spreads from one eye to the other and from person to person. Ear infections commonly occur in children with persistent bacterial conjunctivitis.
Viral conjunctivitis may be associated with an upper respiratory tract infection, cold, or sore throat and may be caused by adenovirus. Viral conjunctivitis sometimes produces a water discharge. While the infection runs its course, the symptoms of viral conjunctivitis can be relieved with cool compresses and artificial tears. For more severe cases, topical steroid drops may be prescribed to reduce the discomfort from inflammation. These are not without side effects, especially with prolonged use.
Allergic conjunctivitis occurs more frequently among those with allergic conditions and may be caused by intolerance to substances such as cosmetics, medications or fumes. For allergic conjunctivitis, cool compresses and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, non-steroidal anti-inflammatory medications and antihistamines may be prescribed. Some patients with persistent allergic eye infections may also require topical steroid drops.
Blepharitis is an inflammation of the eyelid margins, and is usually caused by an infection of Staphylococcus aureus. Treatment generally involves cleaning the lid and applying a topical antistaphylococcal antibiotic. Blepharitis can lead to a chalazion, or lead to a stye (hordeolum).
A chalzion is a cyst in the eyelid caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. A chalazion may spawn bacterial infection. When the condition does not resolve on its own, a chalazion may be injected with corticosteroid or be surgically removed.
Hordeola include both external hordeolum, or “stye”, and internal hordeolum (acute meibomianitis). Styes are lesions at the base of the eyelashes and are predominantly caused by infection of Staphylococcus aureus. Treatment may involve draining and topical application of an antibiotic to the lesion.
Infections may afflict the lacrimal system of the eye, such as canaliculitis and dacrocystitis. Canaliculitis can be caused by Actinomyces infection and treatment typically involves mechanical expression of the exudative or granular material from the canaliculi, combined with probing and irrigation of the nasolacrimal system with a penicillin eyedrop solution. Dacrocystitis is often due to streptococci or Staphylococcus aureus and is usually treated with antibiotics.
Rhinitis, an inflammation of the nasal mucous membrane, may produce nasal decongestion and rhinorrhea. Rhinitis is typically of viral origin, but may involve secondary bacterial infection. Acute rhinitis may be treated for symptoms, for example, with decongestants such as pseudoephedrine. Where bacterial superinfection is involved, antibiotics may be administered.
Rhinorrhea and nasal congestion are typically of viral or allergic origin. In certain instances, congestion is observed as an after-effect of topical decongestants (rhinitis medicamentosa). Allergic congestion and rhinorrhea are treated with antihistamines. While topical or oral decongestants (e.g., pseudoephedrine) can provide some symptomatic relief, prolonged use is not recommended.
Otitis media, inflammation of the middle ear structures, can lead to loss of equilibrium and deafness. Otitis media is generally of bacterial or viral origin. Viral infections may spawn secondary bacterial infections, including infections of Streptococcus pneumonia, Moraxella catarrhalis, and non-typable Haemophilus influenzae. Where bacterial infection is suspected, the condition may be treated with antibiotics, as well as analgesics.
External otitis is an acute or chronic inflammation of the external ear canal, and may involve bacterial (e.g., Pseudomonas aeruginosa, Proteus vulgaris, and Staphylococcus aureus) or fungal (e.g., Aspergillus and Candida) infection. External otitis may be treated with, for example, antibiotics and corticosteroids.
Pharyngitis (sore throat) is characterized by pain and swelling in the posterior pharynx. Pharyngitis is commonly caused by bacterial (e.g., Streptococcal) or viral infection, and may be treated with topical anesthetics.
Stomatitis is a painful ulcer or inflammation of the oral mucosa. Stomatitis may be caused, for example, by infection (bacterial, viral, or fungal), chemical irritant, or allergic reaction, and may be common for patients having Xerostomia. Some common infectious agents include herpes simplex virus, varicella zoster, Epstein-Barr virus, influenza, cytomegalovirus, Gonorrhea, and Candida. Treatments for stomatitis include anesthetics, corticosteroids, antihistamines, and/or antibiotics.
It is an object of the invention to provide a broadly effective and safe treatment for conditions characterized by infection (bacterial, viral, or fungal), and/or inflammation (including acute and chronic inflammation, as well as delayed-type and immediate-type hypersensitivity), so as to avoid development of bacterial resistance to antibiotics, and so as to avoid toxicity, irritation, and/or hypersensitivity that may occur with conventional agents.